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Hospital Facilities (Continued)

Thursday, 29 April 2021

Dáil Éireann Debate
Vol. 1006 No. 3

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(Speaker Continuing)

[Deputy Brendan Smith: Information on Brendan Smith Zoom on Brendan Smith] In this day and age, that is not acceptable. I know of young people who are in dire need of orthopaedic surgery yet are on long waiting lists. In the meantime, their conditions continue to deteriorate. The State has an obligation to ensure that no child is denied unduly the treatment and surgery he or she needs.

Deputy Jackie Cahill: Information on Jackie Cahill Zoom on Jackie Cahill I thank the Ceann Comhairle for picking this Topical Issue and giving us an opportunity to discuss it, and I thank the Minister of State, Deputy Rabbitte, for attending.

I visited Cappagh hospital earlier this week and received a briefing from its chief executive, Ms Angela Lee, and one of its surgeons, Mr. Connor Green. Its excellence, capacity, figures and results are phenomenal but it is an old-style structure and there are issues with meeting HIQA's standards. Its high-dependency unit greatly restricts its capacity to operate its five theatres.

The hospital has three key demands: a new ten-bed high-dependency unit; 76 single occupancy rooms; and three additional operating theatres. If this infrastructure is put in place, we will have a great opportunity nationally to reduce waiting lists. Each of us has many people in our constituencies who are constantly contacting our constituency offices trying to get orthopaedic operations done. It is particularly galling to see young people waiting long periods for essential surgery.

The hospital has a 30-acre site. I will not raise the issue of the children's hospital or the long debate on same, but the hospital in Cappagh has the room for this new infrastructure. It believes it can double the number of surgeries it performs if this investment is made. As Deputy Brendan Smith stated, the hospital has produced detailed figures, which are with the Department of Health now. In a modern context, the contribution it is seeking from the Exchequer is not significant. For an investment of €34.5 million, it could provide this infrastructure, although that would only be for the building itself and would exclude VAT and professional fees, for example, architects' fees. It has had detailed discussions on financing the development through a public-private partnership.

The hospital's executive has put serious work into this plan and, for an investment that would be minimal in terms of the health budget, there is an opportunity to increase capacity in the orthopaedic sector greatly. The hospital has the will and capacity to do it.

Minister of State at the Department of Health (Deputy Anne Rabbitte): Information on Anne Rabbitte Zoom on Anne Rabbitte I thank the Deputies for submitting this Topical Issue, which I am responding to on behalf of the Minister, Deputy Stephen Donnelly, and giving me the opportunity to provide an update to the House on waiting lists in National Orthopaedic Hospital Cappagh.

Regarding paediatric orthopaedic waiting times, there has been an increased investment in paediatric orthopaedics and scoliosis services in recent years, which has improved access to surgery and outpatient appointments. In 2018, Children's Health Ireland, CHI, was provided with an additional €9 million to address paediatric orthopaedic waiting lists, including the provision of scoliosis services. This funding supported the recruitment of approximately 60 whole-time equivalents in 2018 and 2019 to enable the expansion of paediatric orthopaedic services, including scoliosis services. The posts related to multidisciplinary teams at diagnosis, pre-assessment, during surgery in theatre and post-operative care.

In general, waiting times for scheduled appointments and procedures have been impacted in the past year as a direct result of the Covid-19 pandemic. Elective hospital care was further curtailed for the first quarter of 2021 in line with the rapid increase in Covid-19 hospital admissions, with only critical time-dependent elective procedures undertaken. This has affected activity in CHI.

Regarding orthopaedics, I am advised that Children's Health Ireland is expanding its activity in Cappagh hospital and is also running additional orthopaedic clinics in Citywest using a new active clinical triage model that is reducing the number of children waiting the longest for appointments. Children's Health Ireland proactively continues to work with the HSE and my Department to reduce waiting times for patients attending the scoliosis service.

I am advised that funding has been provided for additional paediatric orthopaedic clinics at Cappagh orthopaedic hospital and that additional outpatient clinics commenced on the 17 February. I am further advised that additional theatre capacity for day case surgery at Cappagh commenced on 26 April, which should have a significant positive impact through reducing long waiting times for general orthopaedic patients in addition to scoliosis patients.

The Deputies might wish to note that, in January, the HSE added for development a €1.65 million project of an outpatient paediatric clinic to the capital programme, which will be considered for progression subject to availability of funding next year. It is expected that this will further increase Cappagh hospital's capacity for paediatric orthopaedic services.

Deputy Brendan Smith: Information on Brendan Smith Zoom on Brendan Smith I thank the Minister of State for her reply. While I welcome the facts that she laid out, the additional funding will not be transformative enough to reduce the waiting lists dramatically. That is the sad reality.

As Deputy Cahill alluded, and speaking as a former patient myself, the ethos in Cappagh hospital is one of can do, will do. It wants to carry out more procedures and treat more patients but it needs additional theatre capacity and bed capacity. It has to replace some of its outdated existing accommodation and, of course, Covid imposes extra requirements. The hospital wants to meet all the necessary accommodation requirements.

I know some of the children who are on the waiting lists. I am conscious of their suffering and the distress and worry caused to their parents by the long waiting lists to access much-needed treatment. I spoke to the mother of a 14-year-old who was waiting for treatment. I discussed the case with that young boy's mother again last Sunday morning. She said that he had gone back to school. He is not mobile. His friends are participating in their sports but he is not because he cannot get the treatment and surgery he needs. Sadly, there are hundreds of other children in the same predicament. Cappagh hospital has top-class clinicians and support staff who want to treat them, carry out their procedures and give them the quality of life they need, the quality of life that we want to see every child in the country have.

As Deputy Cahill stated, a detailed and costed proposal is with the Department. It could be transformative if the additional capacity was provided. Cappagh hospital is not crying out for additional staff. Rather, it is crying out for additional accommodation in order that it can do more work to ease the pain and suffering of children and adults throughout this country. It is the national orthopaedic centre. It treats patients from every county in our State. We need to give it the resources and capacity that would allow it to reduce waiting lists dramatically. None of us wants to meet in our clinics or talk on the phone to people of all age groups who are suffering and immobile. It is not good enough.

While we know the hardship and suffering that the pandemic has brought to this country and to so many families, the Taoiseach has rightly suggested that it might transform how we deliver healthcare. Let us be transformative and put in place the investment and facilities to ensure that a better quality of life is provided to these people, in particular the children waiting for treatment.

Deputy Jackie Cahill: Information on Jackie Cahill Zoom on Jackie Cahill Deputy Brendan Smith has put it well. Detailed plans have been drawn up for a modern unit. Unfortunately, the current infrastructure will not meet HIQA's standards in future. Investment is essential. The hospital has a tremendous record. It breaks even every year and sees a significant throughput. Its figures are the envy of other hospitals within the health service. We can make a dramatic impact on the waiting list for orthopaedic surgery by investing in Cappagh hospital. It has the necessary space, which is something other hospital sites do not have. I saw its high-dependency unit on Tuesday morning. It is old-fashioned and not fit for purpose. The hospital's single-bed units are not fit for purpose either. An old building, the hospital used to be a convent.

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